浙江省急诊抢救室患者滞留状况的调查研究
发布时间：2019-03-28 15:26
【摘要】：目的：调查浙江省16家综合性医院急诊抢救室滞留状况,为进一步合理快速地分流抢救患者,提高急诊服务质量、完善医院急诊医疗服务体系提供依据。 方法：前瞻性的断面调查研究。2012年12月17日至2012年12月23日全省16家综合性三级医院急诊抢救患者的相关信息,包括出入抢救室时间,医生决定患者住院时间及不同疾病分类,不同去向,不同急迫程度的患者的滞留时间及可能原因。并对比不同等级医院上述结果的差别。 结果：①包括三甲医院9家(其中附属医院4家),三乙医院7家②全省共收集一周抢救患者1728例,急诊滞留时间(0～350h),急诊滞留的时间中位数为4.5h,(四分位数1.8-13.9h)；附属医院601例,急诊滞留的时间中位数11.6h(四分位数2.8-24.7h)；非附属医院1127例,中位数3.3h(四分位数1.7-8.3h)。③不同等级医院对比,非附属三甲医院与三乙医院滞留时间无显著差异,附属医院与非附属医院滞留时间存在显著差异,抢救治疗时间T2(p=0.001),初步抢救后决定住院到实际离开急诊室的时间T3(p0.001)、从预检分诊开始到离开急诊室的时间段T(p0.001),均是附属医院大于非附属医院。④不同去向抢救室患者滞留时间比：全省抢救患者滞留时间前三位为自动出院、入住普通病房、好转出院；⑤不同疾病分类抢救患者滞留时间比：全省抢救患者滞留时间前三位为呼吸系统、多系统、循环系统；⑥滞留6h以上患者67.1%与普通病房无床相关。⑦滞留延长了患者总住院时间。 结论：2012年浙江省急诊抢救室患者整体滞留尚不严重,但附属医院滞留已经相当严重。其中以多系统疾病、呼吸系统、循环系统疾病滞留时间最长。主要与专科普通床位供应不足相关。同时发现自动出院患者及好转出院患者对急诊滞留造成一定影响。滞留对患者影响主要为延长了患者总住院时间。
[Abstract]:Aim: to investigate the detention status of emergency rescue rooms in 16 general hospitals in Zhejiang Province, in order to provide evidence for further rational and rapid diversion of patients, improvement of emergency service quality and improvement of hospital emergency medical service system. Methods: a prospective cross-sectional study was conducted. From December 17, 2012 to December 23, 2012, information about emergency patients in 16 level III hospitals in the province, including the time of entering and leaving the emergency room, was carried out. Doctors determine the stay time and possible causes of patients with different hospital stay and different disease categories, different destinations, and different degrees of urgency. And compare the difference of the above results in different grade hospitals. Results: 1There were 9 Grade A hospitals (including 4 affiliated hospitals), 7 hospitals (7 hospitals) and 7 hospitals (7 hospitals). A total of 1728 patients were collected for one week. The duration of emergency stay (0 / 350 hours) was 4.5 hours, and the median time of stay in emergency department was 4.5 hours. (quartile 1.8 / 13.9 h); There were 601 cases in affiliated hospital, the median stay time of emergency department was 11.6 h (quartile 2.8 / 24.7h). There were 1127 non-affiliated hospitals with a median of 3.3 h (1.7 / 8.3 h). 3. There was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals, compared with different grade hospitals, and there was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals. There was a significant difference in stay time between affiliated hospitals and non-affiliated hospitals. The time of rescue and treatment was T2 (p = 0.001). After initial rescue, the time between hospitalization and actual departure from the emergency room was T3 (p0.001). From the beginning of pre-examination and screening to leaving the emergency room, the time period T (p0.001) was larger in the affiliated hospital than in the non-affiliated hospital. 4 the retention time ratio of the patients in the emergency room at different directions: the first three stay times of the rescuers in the whole province were automatically discharged from the hospital. Admission to the general ward, improvement and discharge; (5) retention time ratio of patients with different diseases classification: respiratory system, multi-system and circulatory system were the first three stay time of rescuing patients in the whole province; 67.1% of the patients with more than 6 h detention were associated with bed-free in general ward. 7 the total hospitalization time of the patients was prolonged. Conclusion: the overall detention of patients in emergency rescue room in Zhejiang Province in 2012 is not serious, but the detention in affiliated hospitals is quite serious. Among them, multi-system disease, respiratory system, circulatory system disease stay time longest. It is mainly related to the shortage of specialized general beds. At the same time, it was found that automatic discharge patients and improved patients had a certain impact on emergency detention. The effect of retention on the patients was mainly to prolong the total length of hospitalization of the patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7
本文编号：2448992
[Abstract]:Aim: to investigate the detention status of emergency rescue rooms in 16 general hospitals in Zhejiang Province, in order to provide evidence for further rational and rapid diversion of patients, improvement of emergency service quality and improvement of hospital emergency medical service system. Methods: a prospective cross-sectional study was conducted. From December 17, 2012 to December 23, 2012, information about emergency patients in 16 level III hospitals in the province, including the time of entering and leaving the emergency room, was carried out. Doctors determine the stay time and possible causes of patients with different hospital stay and different disease categories, different destinations, and different degrees of urgency. And compare the difference of the above results in different grade hospitals. Results: 1There were 9 Grade A hospitals (including 4 affiliated hospitals), 7 hospitals (7 hospitals) and 7 hospitals (7 hospitals). A total of 1728 patients were collected for one week. The duration of emergency stay (0 / 350 hours) was 4.5 hours, and the median time of stay in emergency department was 4.5 hours. (quartile 1.8 / 13.9 h); There were 601 cases in affiliated hospital, the median stay time of emergency department was 11.6 h (quartile 2.8 / 24.7h). There were 1127 non-affiliated hospitals with a median of 3.3 h (1.7 / 8.3 h). 3. There was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals, compared with different grade hospitals, and there was no significant difference in the stay time between non-affiliated tertiary A hospitals and Sanb hospitals. There was a significant difference in stay time between affiliated hospitals and non-affiliated hospitals. The time of rescue and treatment was T2 (p = 0.001). After initial rescue, the time between hospitalization and actual departure from the emergency room was T3 (p0.001). From the beginning of pre-examination and screening to leaving the emergency room, the time period T (p0.001) was larger in the affiliated hospital than in the non-affiliated hospital. 4 the retention time ratio of the patients in the emergency room at different directions: the first three stay times of the rescuers in the whole province were automatically discharged from the hospital. Admission to the general ward, improvement and discharge; (5) retention time ratio of patients with different diseases classification: respiratory system, multi-system and circulatory system were the first three stay time of rescuing patients in the whole province; 67.1% of the patients with more than 6 h detention were associated with bed-free in general ward. 7 the total hospitalization time of the patients was prolonged. Conclusion: the overall detention of patients in emergency rescue room in Zhejiang Province in 2012 is not serious, but the detention in affiliated hospitals is quite serious. Among them, multi-system disease, respiratory system, circulatory system disease stay time longest. It is mainly related to the shortage of specialized general beds. At the same time, it was found that automatic discharge patients and improved patients had a certain impact on emergency detention. The effect of retention on the patients was mainly to prolong the total length of hospitalization of the patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7
【参考文献】
相关期刊论文 前1条
1 叶立刚;张茂;周光居;沈伟锋;何小军;干建新;徐少文;;综合性三甲医院急诊室抢救患者滞留状况的研究[J];实用医院临床杂志;2012年01期
，本文编号：2448992
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